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- July 2019
- Article
Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements
By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed... View Details
- Article
Europe's Alternative to Medicare for All: Swiss and Dutch Private Insurance Provide Better Coverage Than Canada's Single-Payer System
By: Regina E. Herzlinger and Bacchus Barua
An analysis of Canada’s single-payer healthcare system shows the dangers of the proposed Medicare for All model. In fact, the Canadian healthcare system is costly and drives poor outcomes when compared to objective performance measures. Alternatively, the Swiss and... View Details
- Article
Decreases In Readmissions Credited to Medicare's Program to Reduce Hospital Readmissions Have Been Overstated
By: Christopher Ody, Lucy Msall, Leemore S. Dafny, David Grabowski and David Cutler
Medicare’s Hospital Readmissions Reduction Program (HRRP) has been credited with lowering risk-adjusted readmission rates for targeted conditions at general acute care hospitals. However, these reductions appear to be illusory or overstated. This is because a... View Details
- February 2018
- Case
Health Savings Accounts: Enabling Consumer Participation
By: Regina E. Herzlinger and James Wallace
Health savings accounts (HSAs), a creation of the 2003 Medicare Modernization Act, had become an integral part of the drive toward consumer-driven health care. Coupled with high-deductible health plans, HSAs allowed consumers to directly control a significant part of... View Details
- August 2017
- Case
CareMore Health System
By: Robert S. Huckman and Brian W. Powers
CareMore Health System—a physician-founded care delivery system and health plan—had developed and refined an innovative care model for at-risk seniors enrolled in Medicare managed care (i.e., Medicare Advantage) plans. CareMore's President, Sachin Jain, and his... View Details
- August 2017
- Supplement
CareMore Health System (B)
By: Robert S. Huckman and Brian W. Powers
This supplement to “CareMore Health System (A)” discusses the company's early experience introducing its managed Medicaid model in the Des Moines, Iowa, market. It also provides an update on the Memphis program discussed in the (A) case. View Details
- April 2017
- Supplement
Imprimis (B)
By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
This case is a supplement to Imprimis (A). It describes the company’s decision to enter into the pharmaceutical compounding business in 2013–2014. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients’... View Details
- November 2016 (Revised November 2016)
- Case
Radial Analytics Probes Post-Acute Care
By: Richard G. Hamermesh and Olivia Hull
Thaddeus Fulford-Jones and Eric Weiss, founders of healthcare technology startup Radial Analytics, have been busy developing a software program designed to save hospitals money and improve patient outcomes by producing customized care plans for patients leaving the... View Details
Keywords: Electronic Medical Records; Electronic Health Records; Data Science; Entrepreneurship; Health Care and Treatment; Business Model; Business Startups; Innovation and Invention; Growth Management; Marketing Strategy; Product Launch; Product Positioning; Science-Based Business; Business Strategy; Health Industry; Technology Industry; Cambridge; Massachusetts
- Article
Beyond Statistics: The Economic Content of Risk Scores
By: Liran Einav, Amy Finkelstein, Raymond Kluender and Paul Schrimpf
"Big data" and statistical techniques to score potential transactions have transformed insurance and credit markets. In this paper, we observe that these widely-used statistical scores summarize a much richer heterogeneity, and may be endogenous to the context in which... View Details
- Article
Time-driven Activity-based Costing of Multivessel Coronary Artery Bypass Grafting across National Boundaries to Identify Improvement Opportunities: Study Protocol
By: F. Erhun, B. Mistry, T. Platcheck, A. Milstein, V.G. Narayanan and R. S. Kaplan
Coronary artery bypass graft (CABG) surgery is a common treatment for coronary artery disease—a disease that affects over 10% of US adults and is a major cause of morbidity and mortality. In 2005, the mean cost for a CABG procedure among Medicare beneficiaries in the... View Details
- 2010
- Chapter
The Paranoid Style in the Study of American Politics
By: David Moss and Mary Oey
What drives policy making in a democracy? The conventional view is that political actors, like economic actors, pursue their self interest, and that special interest groups dominate the policy making process by satisfying policy makers' need for money and other forms... View Details
Keywords: Policy; Government Legislation; Media; Interests; Power and Influence; Public Opinion; United States
- Fall 2008
- Article
Do Report Cards Tell Consumers Anything They Don’t Already Know? The Case of Medicare HMOs
By: Leemore S. Dafny and David Dranove
- April 2008 (Revised May 2008)
- Case
Commonwealth Care Alliance: Elderly and Disabled Care
By: Michael E. Porter and Jennifer F Baron
Individuals enrolled in both Medicare and Medicaid, known as dual eligibles, are among the highest-cost beneficiaries in the US. Commonwealth Care Alliance, a small nonprofit insurer and care delivery system in Massachusetts, operated under a public demonstration... View Details
- 2008
- Other Unpublished Work
The Paranoid Style in the Study of American Politics
By: David Moss and Mary Oey
The conventional view is that political actors, like economic actors, pursue their self interest, and that special interest groups dominate the policy making process by satisfying policy makers' need for money and other forms of political support. Indeed, many... View Details
Keywords: Policy; Government Legislation; Media; Interests; Power and Influence; Public Opinion; United States
- August 2003 (Revised August 2006)
- Case
HealthSouth Corporation
By: Regina E. Herzlinger and Ivan Cheung
Delineates how a for-profit health services business was created. Focuses on sources of financing, the impact of Medicare reimbursement, and Stark laws against fraud and abuse. View Details
- February 1999
- Case
Lifeline Systems, Inc. (B)
By: H. Kent Bowen and Marilyn Matis
In 1997, Lifeline Systems continues to grow its service business to $32 million, 56% of the company's total revenues. More local hospital Lifeline programs turn over their monitoring service to Lifeline Central, expanding the company's subscriber base by 30%. The... View Details
- February 1993 (Revised August 1995)
- Case